Ricardo Alonso, Laboratorio de urgencias, Hospital Universitario y Politécnico La Fe, Valencia, España
Fco. Javier Lirón, Área de Diagnóstico Biológico, Bioquímica, Hospital Universitario de La Ribera, Alzira, Valencia, España
Cecilia Cueto-Felgueroso, Servicio de Análisis Clínicos-Bioquímica Clínica, Hospital Universitario 12 de Octubre, Madrid, España
Ma. Jesús Lorenzo, Análisis Clínicos, Hospital Clínico Universitario de Vigo, Vigo, Pontevedra, España
Gabriel Yanes, Servicio de Anestesia, Hospital Universitario Virgen del Rocío, Sevilla, España
Sonia Veiras, Servicio de Anestesia, Hospital Clínico Universitario de Santiago, Santiago de Compostela, La Coruña, España
Azucena Pajares, Servicio de Anestesia, Hospital Universitario y Politécnico La Fe, Valencia, España
Raquel Ferrandis, Servicio de Anestesia, Hospital Universitario y Politécnico La Fe, Valencia, España
Marta Baquero, Servicio de Anestesia, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
Rosa Beltrao, ervicio de Anestesia, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
Pilar Paniagua, Servicio de Anestesia, Hospital de la Santa Creu i Sant Pau, Barcelona, España
Esther Méndez, Servicio de Anestesia, Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat, Barcelona, España
Noelia Vilalta, Unidad de Hemostasia y Trombosis, Hematología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
Viscoelastic tests, point-of-care coagulation devices, are key tools in hemorrhage management, especially in surgery, but their use is expanding to other fields such as obstetrics, ECMO patients, and burn victims. While their role in cardiac surgery, polytrauma, and liver transplantation is more established, evidence regarding their impact on mortality remains controversial. One of the main limitations is the lack of result validation, as viscoelastic tests are not comparable to standard coagulation tests, showing significant variability (up to 83% in ROTEM®). Additionally, quality control is not always managed by the laboratory, which may affect reliability. The specialties of anesthesiology, laboratory medicine, and hematology are involved in their interpretation. This document, supported by their respective scientific societies, aims to provide a comprehensive perspective of the functionality, scientific evidence, implementation, quality control, and potential economic benefits of viscoelastic tests.
Keywords: Viscoelastic tests. Point of care. Haemostasis. Bleeding. Surgery. ECMO.